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Video analysis of trunk and knee motion during non-contact anterior cruciate ligament injury in female athletes: lateral trunk and knee abduction motion are combined components of the injury mechanism
  1. T E Hewett1,
  2. J S Torg2,
  3. B P Boden3
  1. 1
    Cincinnati Children’s Hospital, Cincinnati, Ohio, USA
  2. 2
    University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3
    The Orthopaedic Center, Rockville, Maryland, USA
  1. T E Hewett, Cincinnati Children’s Hospital, USA; tim.hewett{at}


Background: The combined positioning of the trunk and knee in the coronal and sagittal planes during non-contact anterior cruciate ligament (ACL) injury has not been previously reported.

Hypothesis: During ACL injury female athletes demonstrate greater lateral trunk and knee abduction angles than ACL-injured male athletes and uninjured female athletes.

Design: Cross-section control-cohort design.

Methods: Analyses of still captures from 23 coronal (10 female and 7 male ACL-injured players and 6 female controls) or 28 sagittal plane videos performing similar landing and cutting tasks. Significance was set at p⩽0.05.

Results: Lateral trunk and knee abduction angles were higher in female compared to male athletes during ACL injury (p⩽0.05) and trended toward being greater than female controls (p = 0.16, 0.13, respectively). Female ACL-injured athletes showed less forward trunk lean than female controls (mean (SD) initial contact (IC): 1.6 (9.3)° vs 14.0 (7.3)°, p⩽0.01).

Conclusion: Female athletes landed with greater lateral trunk motion and knee abduction during ACL injury than did male athletes or control females during similar landing and cutting tasks.

Clinical relevance: Lateral trunk and knee abduction motion are important components of the ACL injury mechanism in female athletes as observed from video evidence of ACL injury.

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  • Competing interests: None.

  • Funding: This work was supported in part by NIH/NIAMS grants R01 AR049735, R01 AR05563 and R01 AR056259 (TEH).

  • Ethics approval: Ethics approval was obtained.

  • ▸ Additional data (Supplementary figure 1) are published online only at